A nurse is reinforcing teaching with the family of a client who is receiving palliative care for terminal cancer. Which of the following guidelines should the nurse emphasize about appropriate pain control measures?
Administer pain medication on a regular schedule.
Administer pain medication with caution to avoid addiction.
Administer a placebo if it is not time for pain medication.
Administer scheduled doses of medication from a patient-controlled analgesia (PCA) pump.
The Correct Answer is A
A. Administer pain medication on a regular schedule: In palliative care, maintaining consistent pain control is essential for comfort and quality of life. Scheduled administration prevents the recurrence of severe pain, reduces stress on the client, and avoids peaks and troughs in analgesic effect, which is more effective than waiting for pain to become severe.
B. Administer pain medication with caution to avoid addiction: In terminal cancer, the priority is comfort. Concerns about addiction are less relevant because the goal is effective pain management rather than long-term dependence. Opioid use in palliative care is aimed at symptom relief, not recreational use.
C. Administer a placebo if it is not time for pain medication: Placebos are unethical and ineffective in palliative care. Using a placebo can damage trust between the family, client, and healthcare team and does not provide actual analgesic benefit.
D. Administer scheduled doses of medication from a patient-controlled analgesia (PCA) pump: PCA pumps allow the client to self-administer doses and are not typically used for routine scheduled administration by family members. Family-administered dosing should follow prescribed schedules rather than PCA programming, which requires monitoring and education.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Speech-language pathologist: Speech-language pathologists (SLPs) are trained to assess and manage dysphagia, including swallowing difficulties after a stroke. They evaluate swallowing function, recommend safe feeding techniques, and provide exercises to improve swallowing ability, directly addressing the client’s expressed concern.
B. Physical therapist: Physical therapists focus on mobility, balance, and strengthening exercises. While important for post-stroke rehabilitation, they do not specialize in swallowing assessment or management. Referral to a PT would not address the client’s immediate swallowing difficulties.
C. Social worker: Social workers provide support for psychosocial needs, discharge planning, and community resources. Although valuable for overall care, they are not responsible for evaluating or treating swallowing disorders.
D. Occupational therapist: Occupational therapists assist with activities of daily living, adaptive equipment, and fine motor skills. While they may help with feeding techniques, the primary assessment and management of dysphagia require an SLP.
Correct Answer is C
Explanation
A. Evaluating the effectiveness of acetaminophen administered 30 min ago to a client who reported a headache: Assessing medication effectiveness requires professional judgment to evaluate pain relief, side effects, and changes in condition. This is within the registered nurse’s scope of practice and cannot be delegated to an assistive personnel (AP).
B. Discussing upcoming dietary changes with a client who has a new prescription for a low-cholesterol diet: Teaching about diet involves interpretation, assessment of understanding, and individualized instruction, which are nursing responsibilities. APs cannot provide education about new prescriptions or therapeutic diets.
C. Measuring urine output every 2 hr for a client recently diagnosed with a urinary tract infection: Measuring and recording urine output is a routine, stable, and predictable task that does not require professional judgment. APs are qualified to perform this task under supervision, making it appropriate for delegation.
D. Inserting a temporary nasogastric tube for a client who has a prescription for laboratory analysis of stomach contents: Nasogastric tube insertion is an invasive procedure requiring skill, assessment, and clinical judgment. It falls within the registered nurse’s scope of practice and cannot be delegated to an AP.
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